Evaluating drug treatments for Parkinson's disease: how good are the trials?

摘要

The prevalence of Parkinson's disease will increase as the population ages, making it important to identify reliably the most effective drug therapy. Although many randomised controlled trials have evaluated the efficacy of different classes of drugs in both early and later Parkinson's disease, uncertainty about best treatment remains because of small numbers, inadequate follow up, and inappropriate end points. Much larger trials are needed with long term follow up and end points of relevance to patients. Large simple pragmatic trials have improved treatment of heart disease, stroke, and cancer and their methods should be applied to Parkinson's disease and other neurodegenerative diseases.